Breast milk interactions chart

Breast milk interactions chart

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What you eat, drink, and smoke can travel from your bloodstream to your breast milk. Learn how herbs, caffeine, nicotine, and marijuana could negatively affect your milk supply and your baby – and what you can do to reduce the risks.

Talk to your baby's doctor, your doctor, or a pharmacist if you have any questions about how something you ingest or smoke can interact with your breast milk. The charts below describe:

  • Special concerns associated with herbs and breastfeeding
  • The effects of alcohol, caffeine, marijuana, and nicotine on breast milk – and what precautions you can take to keep your nursing baby safe

You can also research the safety of herbs and medications with LactMed, a database compiled by the U.S. National Library of Medicine. It's available online and in a mobile app.

Are there foods to avoid while breastfeeding?

Foods you'll want to limit when you're breastfeeding include certain types of fish. Eating 8 to 12 ounces of most types of fish and seafood per week is good for you and your baby, but when you're breastfeeding avoid fish with high levels of mercury.

Despite what you may have heard, foods you eat will not make your nursing baby gassy or more fussy. That said, every baby is different, so if you notice a pattern that a certain food seems to bother your baby, talk to the doctor. If she seems to be reacting to something in your diet, the most likely culprits are cow's milk or soy.

Is it safe to take medicine while breastfeeding?

Most medications are safe to use when you're breastfeeding. However, small amounts will get into your milk, and some medications may affect your milk supply. To be safe, check with your child's doctor, your doctor, or a pharmacist before taking any kind of medication, even over-the-counter drugs. You can also refer to the following resources for more information:

  • Drug safety and breastfeeding charts: Medicines are divided into four lists based on those that are safe, are most likely safe, may cause problems, and are unsafe to take while breastfeeding.
  • LactMed and MotherToBaby: This database and information service, respectively, provide fact sheets on how specific medications can affect a breastfeeding baby.

Is it safe to take herbs while breastfeeding?

It depends. Herbs and herbal products may be considered "natural," but they aren't necessarily safe. Since herbs can be very potent, it's important to check with your healthcare provider before using them, including herbal teas and essential oils.

As with pharmaceutical medications, herbs can get into breast milk and possibly affect your milk supply and your baby. (It's a myth though that peppermint, parsley, or sage will decrease your milk supply.)

But unlike over-the-counter and prescription medicines, herbs aren't regulated by the Food and Drug Administration (FDA), so there's no guarantee of safety, strength, or purity. And very few herbs have been studied to learn their effect on nursing infants – so even the experts aren't completely sure what's safe and what's not.

Herbs such as fenugreek and fennel, for example, have been used for centuries to boost a nursing mom's milk supply, but there's little data to show that they're safe (or effective) in nursing moms and infants.

Echinacea, which is used to prevent or treat colds, is another commonly used herb to approach with caution. Some experts cite a lack of safety data and advise moms to avoid it while breastfeeding. Also, echinacea is often paired with goldenseal, which can be toxic in even moderate doses.

Play it safe and consult your healthcare provider before taking any herbal remedy.

Most herbs used to season food – such as cumin, rosemary, and cilantro – are fine to include in your everyday diet in moderate amounts. But some, like sage, can cause problems if you consume them in large or concentrated amounts, such as medicinally or in teas.

There are some interactions between herbs – and between herbs and drugs – that you should be aware of. Consult your doctor or pharmacist for more information.

When researching herbs online, look for reliable, noncommercial sites rather than those that are selling herbal products. The National Institutes of Health, U.S. Department of Agriculture, MedlinePlus, and LactMed are good sources.


What you should know if you're breastfeeding

Herbal teasDrink all herbal teas with caution and only in moderate amounts. Herbs in teas are concentrated. Select teas that list all the ingredients. Chamomile (German) or ginger tea are considered safe, for example, but stay away from any tea with goldenseal.
Aloe, anise, blue cohosh, buckthorn bark and berry, caraway oil, cascara sagrada bark, coltsfoot leaf, comfrey, germander, gordolobo yerba tea, Indian snakeroot, Jin Bu Huan, kava, margosa oil, mistletoe, pennyroyal oil, peppermint oil, petasites, rhubarb root, sage, skullcap, uva ursi, yerba mate teaAvoid these herbs. Some interfere with lactation and some could be harmful to your baby.
Blessed thistle, borage, false unicorn root, fennel seeds, fenugreek, goat's rue, raspberry leaves, stinging nettles, vervain (also called verbena)Consult your doctor before taking any of these herbs. Though herbs such as fenugreek have been suggested to boost milk production, most have not been scientifically proven to be safe or effective.
Feverfew (used to treat migraines)Avoid feverfew. There isn't enough information on the safety or effectiveness of this herb in breastfeeding moms and infants.
St. John's wort (used to treat depression)Avoid St. John's wort. This herb can interact dangerously with many drugs and can decrease the effectiveness of hormonal contraceptives. Its full effects on nursing infants are unknown, but the Natural Medicines database reports that nursing infants of mothers who take St. John's wort may get listless or drowsy and experience colic.
Chaste tree berryAvoid chaste tree berry. While this herb has been touted to boost milk production, it's potentially unsafe. Some studies show that the herb decreases rather than increases lactation.

What about using alcohol, caffeine, marijuana, or nicotine while breastfeeding?

It's just as important to protect your baby from the effects of alcohol, caffeine, nicotine, and marijuana while breastfeeding as it was when you were pregnant. The chart below describes how these substances can affect your breast milk – and what you can do to safeguard your baby.

SubstanceWhat it doesWhat you can do

How much alcohol your baby gets from breast milk depends on how much you drink and when. Alcohol levels in breast milk peak about 30 to 90 minutes after your last drink. But it takes two to three hours for one drink to clear your system.

Drinking alcohol can harm your baby's motor development and adversely affect his eating and sleeping.

It's safest to abstain, but an occasional drink is okay if you take precautions and time it. After you drink alcohol, wait at least two hours per drink before breastfeeding. You can pump breast milk before having a drink to feed your baby later.

Taking in more than 300 mg of caffeine a day might affect your baby. When caffeine enters your bloodstream, a small amount ends up in your breast milk.

Your baby's body can't easily break down and excrete caffeine, especially in the first few months of life, so over time it may accumulate in her system. It may make her irritable and cause sleeping problems.

Limit your caffeine intake to less than 300 mg per day – maybe even less if you're nursing a newborn or preterm baby. This is about the amount in three 5-ounce cups of coffee.

In addition to coffee, tea, and energy drinks, some soft drinks and dark chocolate contain caffeine. Check our caffeine chart to see how much is in popular beverages and foods. If your baby seems too wakeful and excited, try cutting back on caffeine.

When you smoke marijuana, small amounts of THC (the psychoactive component of the drug) appear in your breast milk. Secondhand smoke increases your baby's exposure to the drug.

There are no conclusive studies on the effects of THC on breastfed babies, so the risks are unknown. Studies show THC can decrease the quantity of breast milk.

The American Academy of Pediatrics and the American College of Obstetrics and Gynecologists recommend that breastfeeding women abstain from marijuana use.

If you smoke, the amount of nicotine in your breast milk is greater than the amount in your bloodstream. Cigarette smoke contains about 4,000 chemicals, including more than 60 carcinogens. How many of these chemicals are found in a smoker's breast milk, and at what levels, has not been determined.

Studies show that babies sleep less when their mothers smoke prior to breastfeeding. Heavy smoking can significantly reduce your milk production and cause early weaning.

Stop smoking if you can – for your sake and your baby's.

If you can't quit yet, limit yourself to as few cigarettes as possible, consider switching to cigarettes with less nicotine, and try not to light up before a feeding. Smoking immediately after breastfeeding provides some time for the amount of nicotine in your milk to decrease.

Nicotine patches are safe to use when breastfeeding; the lower the dose of the patch, the less nicotine your baby will get.

Never smoke around your baby, inside your home or car, or in any other closed area where your baby may be. Wash your hands and face, and change your shirt, after smoking.

Watch the video: How to increase the breast milk Production. Home Remedy for breast feeding mothers (July 2022).


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